Aim:To assess the potency of unilateral external fixation as a proper cure for tibial fractures. Study design: A retrospective longitudinal study Place and duration: This study was conducted at Pakistan Institute of Medical Sciences (PIMS) Islamabad Pakistan from August 2020 to August 2021. Methodology:Treatment of 225 tibial shaft fractures was done, in which closed fractures took 22 weeks and open 26 weeks for complete fusion. All fractures were fixed with AO fixator Results:Data of 210 patients was evaluated. Treatment of 225 tibial shaft fractures was done, in which closed fractures took 22 weeks and open 26 weeks for complete fusion. A total of 17 nonunion patients were observed while there were 22 delayed fusions, 5 malunion, 59 pin infections, and 4 osteomyelitis, 43 patients went through the re-operation process. Conclusion:Four patients had fat embolism while pulmonary embolism was present in six and venous thrombosis in 15 patients. The ultimate treatment in 88.0% of patients was external fixation. If there is a no formation of callus formation, reoperation should be carried out so unilateral external fixation is the preferred treatment for tibial fractures. Keywords: External Fixation, Tibial Diaphyseal Fractures, treatment

Aim: Assessment of the consequences of arthroscopic repair of large and massive rotator cuffs. Study design: Retrospective analysis Place and duration: This study was conducted at Shaheed Zulifqar Ali Bhutto Medical University/PIMS Islamabad Pakistan from August 2020 to August 2021. Methodology: In the current study, 50 patients were included out of which 37 patients had large tears and 13 had massive tears which were repaired arthroscopically. Average follow up was of 32 months. Modified UCLA shoulder rating scale was used to evaluate the function, strength, range of motion and the pain before and after surgery. Results: Among the included 50 patients, 21 patients were female, and 29 were male. The range of their ages was between 41 and 76 years. The dominant extremity was affected in majority of patients. The average preoperative time of patients was 10 months. According to UCLA, 98% patients experienced satisfactory results, and only 1 patient had to undergo second surgery for the repair. Conclusion: The study concluded that arthroscopic repair of tears in rotator cuffs is the best technique which can be used for repairing large and massive tears in rotator cuff. Keywords: tears, outcome, arthroscopy, rotator cuff

Aim: of the study was to compare the functional outcome in patients undergoing navigation and conventional total knee replacement. secondly to compare the component alignment in patients undergoing navigation and conventional Total Knee Replacement. Materials and methods: Total 80 patients were included in study out of which 40 patients were in each group. All the surgeries were done by single surgeon and subvastus approach was used for all the total knee replacements. Pre-operative functional assessment was done by KSS score14. Preoperative radiological grading of osteoarthritis was done using AHL back. Post operatively all patients were followed upto 1,3 and 6 months and at the end of 6 months radiological assessment of the components was done by measuring Alpha, beta, gamma and sigma angles. Conclusion: Navigation TKR significantly improves the alignment of both femoral and tibial components when compared with the conventional TKR. However there was no significant difference in functional outcome between the two methods. Probably a long term study might highlight on if navigation has a role in improving the longevity of the implant.